COLLEGE OF MEDICINE AND HEALTH SCIENCES

SCHOOL OF NURSING AND MIDWIFERY/HUYE CAMPUS

FINAL EXAM

MODULE NAME: Health services management

MODULE CODE: NUS3152
CREDITS:5
PROGRAM: General Nursing, Advanced Diploma (Year three)
ACADEMIC-YEAR: 2017-2018
TRIMESTER:1
DATE AND TIME: Monday, 08th January,2018, From 2:00 pm-03:30 pm
DURATION FOR EXAM: 1h 30 min
TOTAL MARKS: 50 Marks
MODULE TEACHING TEAM:
NSABIMANA Samuel
MUKAMARARA Immaculeé
DUSHIMIMANA Sandrine

INSTRUCTIONS:

 Read carefully and attempt all 29 questions and their Sub-questions

 Cheating, Attempted cheating or Facilitation in Cheating is Punished as stipulated
in UR academic regulations
 The examination is made up of four sections including multiple choice questions;
True and False questions, Cross-matching questions and case studies
 For multiple choice questions, from question no. 1-10, each correct answer is 1.5
mark
 From question no. 11-22, each correct answer is 1 mark. Question no. 23 scores 2
marks
 Answer by respecting order of questions
 Regarding multiple choice question you do not have right to change your first
choice
 Questionnaires should be submitted with the Exam Answer Booklets
 Write your student reference number on your questionnaire

Page 1 of 10
SECTION I: MULTIPLE CHOICE QUESTIONS (29 Marks)

1.Which of the following terms is explained as the process of reaching

organizational goals by working with and through people and other
organizational resources and knowing what you want people to do, and then
getting them to do it the best way:
a. Leadership
b. Management
c. Planning
d. Organizing

2. Routine assessment of ongoing activities and progress overtime is the

definition of one of the following terms:
a. Supervision
b. Evaluation
c. Controlling
d. Monitoring

3. An appropriate time plan for distributing work among staff members in turn
is:
a. A timetable
b. A schedule
c. A Duty Roster
d. A Calendar

4. Which of the following Questions should be asked by the Manager in case

she/he is evaluating the effectiveness?
a. Are the results as good as they could be? If not, why not? (Performances)
b. Are the results as they are planned? Are the results significant?
(effectiveness)
c. Can the same results be achieved at lower costs? If yes, which resources to be
substituted? (Economy of Resources)
d. What is the level of performance of activities?

5. The Manager of a certain institution used to keep his mind available for
significant information, on which he will be required to act. Which of the
following management principles is he applying?
a. The substitution of resources
b. Management by Exception,
c. The short cut to a decision
Page 2 of 10
d. Management by Objective

6. In relation to functions of management, which of the following statements is

True?
a. Staff deployment involves Monitoring and Control, Logistics, Accounting and
Organization
b. Resource’s mobilization and allocation include organization, directing and
Supervision
c. Implementation consists of situational analysis, setting objectives and
determination of activities
d. Organization involves assigning tasks, communications, Coordination and
Staff deployment

7. Which of the following statement is not True as regards to Budget

monitoring?
a. The manager’s monitoring role is to investigate budget variances, to identify why
the variance occurred and to take management action to bring the budget back in
line.
b. During the activity of monitoring, the budget variance should surely be
considered as an indication of poor management performance
c. The designated budget holder should be given responsibility and accountability to
be able to control spending in terms of the major expenditure items.
d. It is essential to monitor budget on a regular basis and this should be carried out a
minimum of once a month.

8. Which of the following statements is TRUE as regards to four basic functions

of drug management cycle?
a. Deciding which drugs will be available at each level of health care facility is
related to the function of the drug use
b. Calculating the Average Monthly Consumption and Order Quantity is about
the function of the drug selection.
c. Cleaning, maintaining, ventilating & drying, locking and organizing storage area
is about the function of distribution.
d. Accurate diagnosing and Correct dispensing of drugs concerns the function of the
drug procurement.

9. Mr. James is a data manager in a certain Health center. Last year (2016), he
compared health data between people of different ages and with standard and
norms. After presenting data in a table and on a pie chart, He identified the

Page 3 of 10
equivalences and various changes. Which of the following steps was
implemented by Mr. James?
a. The correction of information or Data
b. Organizing and Analyzing information
c. The interpretation of information and decision making
d. The dissemination of information.

10. Which of the following options illustrate better the four stage of
management of material/equipment?
I. Ordering and storing
II. Selecting and procurement
III. Issuing, controlling and monitoring
IV. Distribution and use
a. I and II
b. II and III
c. I and III
d. III and IV
11. The following statements are True except one:/ 1 mark

a. The strategic level of Management has the utmost authority

b. The work division also called division of Labor leads to more work
inefficiency because some of employees may benefits from it and come late to
work.
c. Although Leadership and Management are theoretical different, they somehow
overlap in practice.
zxxxxxxxxxxxxxxxxxxxxxd. Accountability cannot be escaped.

12. Quality assurance principles are focused on:

a. Systems and processes
b. Developing guidelines settings standards
c. Communicating standards and specifications
d. Monitoring quality
e. Quality Assurance measurement
f. a and e
g. c and e

13. The following statements are included in the steps of Quality assurance
process, Except one

a. Developing guideline settings standards

Page 4 of 10
b. Communicating standards and specifications
c. Monitoring quality
d. Quality management
e. Defining the problem
f. Choosing a Team

14. In the following definitions, which one is correct for data?

a. An element of information
b. An indicator of good achievements
c. A dimension of QA
d. A principle of Quality Assurance.

15. As future nurse who have learned advantages of QA, identify the one which
is wrong:
a. Make the customer a partner who is consulted regularly
b. Ensure confidentiality of health related records
c. Improve the communication between users of health facilities and improve the
understanding of needs and expectations of community.
d. Give to staff the opportunity to demonstrate their excellent performances and
reinforce the professional satisfaction
e. Develop the maturity and capacities of the staffs through the resolution of
problems in team
f. Allow the improvement of the support system and management.

16. Identify what is the dimension of quality among the following statements:
a. Many managers think that to achieve to the quality you must have more resources
b. Geographical access may be measured by modes of transportation, distances,
travel time, and any other physical barriers that could keep the client from
receiving care.
c. Quality assurance requires a commitment to find out what patients and community
needs, wants, and expects from health services.
d. Developing the maturity and capacities of the staffs through the resolution of
problems in a team.

17. Which of the following objectives indicates what is appropriate to hospital

accreditation.
a. Continues quality improvement: using the accreditation process to bring
about changes in practice that will improve quality of care for patients.
b. Raising awareness at national level and encouraging debate by interested
stakeholders to develop consensus on launching hospital accreditation.
Page 5 of 10
c. Strengthening hospital inspection units and improving administrative procedures
in ministries of health in preparation for launching accreditation.
d. a & b
e. b & c

18. Among these challenges of QA, one is not included:

a. The implementation of QA doesn’t always eliminate all problems and usual
conflicts.
b. In QA the systematic changes take a long time to get. (A time to review all system
and processes)
c. Quality of care must be defined in the right of the provider’s technical standard
and patients’ expectations.
d. Social or cultural access relates to services acceptability within the context of the
clients’ cultural values, beliefs, and attitudes

19. Quality Assurance is defined as:

a. QA is the correct implementation of health interventions according to established
norms and procedures, which satisfy the health system’s clients and maximize health
outcomes;
b. QA is a system of routine technical activities, to measure and control the quality
of the inventory as it is being developed;
c. Quality Assurance is the set of activities that are carried out to monitor and
improve performance so that the care provided is as effective and as safe as
possible;
d. The application of medical science and technology in a way that maximizes its
benefits to health without correspondingly increasing its risks.
e. All are correct.

20. To achieve the expected health care outcomes, standards must be:
a. Realistic. Reliable, Valid, Clear and Measurable;
b. Communicable, Valid, Clear Measurable and Realistic;
c. Realistic. Reliable, Continuous, Safe and Measurable;
d. Measurable, Valid, Clear, effective and interpersonal relation;
e. Continuous, Valid, Safe, Measurable, Reliable

21. In health care the following stage are used in order to improve quality:
a. To identify, to analyze, to develop, to teste and to apply;
b. To plan, to do, to Study and to Act;
c. To plan, to do, to Study, to development and to Act;
d. To identify, to plan, to develop, to apply.
Page 6 of 10
22. When you need to determine the if there is a change in QA process, you use:
a. Run Chart
b. Histogram
c. Scatter diagram
d. Check Sheets
e. Client Window

23. The matron of surgical ward at Nyanza Hospital, observe that the wound
infection is increased during two weeks ago, and you are there as student in
clinical practice, after finishing Quality Assurance course. Choose within the
following QA tools what you will propose her, in order to found the resources
of this infections:/ 2 marks
a. Client window
b. Fishbone diagram
c. Benchmarking
d. Gantt chart
e. Check list

SECTION II: TRUE AND FALSE QUESTION

24. Tell whether the following statements are TRUE or FALSE /5 Marks
24.1. The medical record is an important practice tool to use, regardless of specialty,
bsecause it supports and enhances the care that our patients receive.
24.2. While Leadership and management are theoretically distinct, in practice they
overlap. TRUE
24.3. Conciliation as a conflict management strategy is the act of procuring good
will.
24.4. The purpose of medical equipment management is to get the right quality
regardless of the quantity of medical materials or equipment.
24.5. Motivation is similar to inspiring.

25. Answer by True or False to the following statements: / 3.5 marks

25.1. Histogram is a statistical tool TRUE

25.2. Domination by the possible individual members is one of advantages of the
team work. FALSE
25.3. Interpersonal Relations is an element of QA principles. FALSE
25.4. System of information in management can measure the client satisfaction.
TRUE
Page 7 of 10
25.5. The following people are client of UR:

A. Principal of Huye Campus as external client or customer FALSE

B. HOD of Nursing Departments as an internal client or customer TRUE
C. Module Leader of Health Services Management as external client or customer
FALSE

SECTION III: CROSS-MATCHING QUESTIONS: / 3.5 Marks

26. Relates these International Standard Organizations (ISO) to their Significances:

International Standard Significances

Organizations (ISO)
A.ISO 9000 J H. Environmental management
B. ISO 14000 H I. Risk management
C. ISO 26000 K J. Quality management
D. ISO 45001 M K. Social responsibilities
E. ISO 639 L L. Language codes
F. ISO 27001N M. Occupational Health and Safety
G. ISO 31000 I N. Information security

SECTION IV: ESSAY QUESTIONS (CASE STUDIES) / 9 Marks

Read each scenario and identifies the leadership styles that is being used. Write
a short answer to support your choice.

27. Scenario 1 / 3 marks

Gahigi is an infection control nurse at the Hospital. He has worked in this position
for two years.
When he came into this position, the hospital had a high HAI (Hospital Acquired
Infection) rate. During this time as the infection control nurse, he has made it clear
that all units must reduce their HAI rates. He has demanded that all departments to
show results within two (2) months. Department which cannot reduce infections rate
will be reported to the ministry as warnings.
a. Name the Leadership style that was applied.
b. Support your choice briefly, maximum 3 lines

Page 8 of 10
28. Scenario 2 / 3 marks

A recent observation showed that the hospital staff are on phone calls excessively at
work. Nkurunziza is the director of the internal medicine department. He has been
informed about the new policy on minimizing personal phones calls at work. He was
given the responsibility of implementing this policy. He had time to involve the team
in the decision making process of how they will implement the change. So
Nkurunziza consulted widely with his team. He involved the team in planning and
implementation. He encouraged his team leaders to put forward ideas and develop
plans to assist with implementation of the new policy without causing a lot of
dissatisfaction.
a. What was the Leadership style that Mr. Nkurunziza used in this Scenario?
b. Briefly, Justify your answer, maximum 3 lines.

29. Scenario 3 / 3 marks

Feza is a hospital administrator at local hospital in Kigali. She has been working in
this position for the last 5 years. Whenever there is a new staff member at the
hospital, Lillian introduce herself to them on their first day. She arranges a short
orientation about the vision and mission of the hospital for them. She also asks new
staff members regarding their expectations and goals and how to align with the
vision of the hospital. Once they work on goal setting she works on a follow up plan.
This plan allows the staff to achieve their professional goals, improve their
performance and encourages their professional growth. It also allows Feza to work
with her staff and guide them to achieve their goals while ensuring delivery of high
standard of care.
a.Identify the Leadership style that Mrs. Feza applies in this Scenario
b. Explain your choice briefly, maximum 3 lines

HAPPY NEW YEAR 2018

Page 9 of 10
Page 10 of 10